Elke Cumps

Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003

Objective: This study determines the injury rate (%) and the associated direct medical and indirect costs of sports injuries in Flanders. Setting: Epidemiological cohort designs and a human capital method were set up to measure respectively the medical direct and indirect cost of sports injuries. Participants: 72 out of 82 Flemish sports federations participated. Intervention: Insurance statistics from 2003 were used to determine the overall rate of injury and injury localisations. Using these data, the medical direct cost and the impact sports injuries have on indirect costs were estimated. The indirect costs were determined by multiplying the days of absence from work with the daily cost resulting from a loss of production, being €200. Main outcome: The total direct medical cost extrapolated for the Flemish sports participants was €15 027 423, which amounted to 0.07% to 0.08% of the total budget spent on healthcare. The indirect cost extrapolated for the Flemish sports participants was €111 420 813, which is about 3.4% of the costs arising from absenteeism from work. Results: Of the 14 in-depth analysed sports, the rate of injury was highest in European team handball (8.96%; 95% confidence interval (CI) 8.95–8.96) and lowest in swimming (0.62%; 95% CI 0.62–0.62). The highest direct medical cost was found for anterior cruciate ligament (ACL) injuries (€1358 per injury) and the lowest for foot injuries (€52 per injury). Conclusion: The costs calculated in this study could become critical statistics in medical care debates. Data obtained here will enable a cost−benefit analysis of the impact of preventive measures to be made.

Effect of a preventive intervention programme on the prevalence of anterior knee pain in volleyball players

Abstract Chronic knee disorders, such as patellofemoral pain syndrome and patellar tendinosis, are common injuries in volleyball players. Using a randomized clinical trial, the aim of the present study was to determine the effect of a 4-month in-season intervention programme on the prevalence of anterior knee pain in volleyball players. No significant differences were observed between the intervention and control group for the prevalence of anterior knee pain after the intervention programme (odds ratio =1.58 [95% confidence interval: 0.60–4.20]). Also, no significant differences were observed for individuals with previously sustained anterior knee pain (OR =0.81 [95% CI: 0.33–2.20]). It was revealed that the risk for recurrent anterior knee pain is significantly higher than the risk for newly sustained anterior knee pain (OR =5.79 [95% CI: 1.59–21.00]). In conclusion, we were unable to confirm any preventive effect of the intervention programme on the prevalence of anterior knee pain. However, a previous study using the same intervention and measuring the effect on the intrinsic risk factors of anterior knee pain showed a positive effect.

Efficacy of a 3 month training program on the jump-landing technique in jump-landing sports. Design of a cluster randomized controlled trial

BackgroundWith the relatively high rate of injuries to the lower extremity due to jump-landing movement patterns and the accompanied high costs, there is need for determining potential preventive programs. A program on the intervention of jump-landing technique is possibly an important preventative measure since it appeared to reduce the incidence of lower extremity injuries. In real life situations, amateur sports lack the infrastructure and funds to have a sports physician or therapist permanently supervising such a program. Therefore the current prevention program is designed so that it could be implemented by coaches alone.ObjectiveThe objective of this randomized controlled trial is to evaluate the effect of a coach supervised intervention program targeting jump-landing technique on the incidence of lower extremity injuries.MethodsOf the 110 Flemish teams of the elite division, 24 teams are included and equally randomized to two study groups. An equal selection of female and male teams with allocation to intervention and control group is obtained. The program is a modification of other prevention programs previously proven to be effective. All exercises in the current program are adjusted so that a more progressive development in the exercise is presented. Both the control and intervention group continue with their normal training routine, while the intervention group carries out the program on jump-landing technique. The full intervention program has a duration of three months and is performed 2 times a week during warm-up (5-10 min). Injuries are registered during the entire season.DiscussionThe results of this study can give valuable information on the effect of a coach supervised intervention program on jump-landing technique and injury occurrence. Results will become available in 2011.Trial registrationTrial registration number: NTR2560

A 3-Month Jump-Landing Training Program: A Feasibility Study Using the RE-AIM Framework

CONTEXT Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. OBJECTIVE To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. DESIGN Randomized controlled trial. SETTING National and regional basketball teams. PATIENTS OR OTHER PARTICIPANTS Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. INTERVENTION(S) All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. MAIN OUTCOME MEASURE(S) The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. RESULTS The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). CONCLUSIONS Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries.

The Effect of a 3-Month Prevention Program on the Jump-Landing Technique in Basketball: A Randomized Controlled Trial

CONTEXT In jump-landing sports, the injury mechanism that most frequently results in an injury is the jump-landing movement. Influencing the movement patterns and biomechanical predisposing factors are supposed to decrease injury occurrence. OBJECTIVES To evaluate the influence of a 3-mo coach-supervised jump-landing prevention program on jump-landing technique using the jump-landing scoring (JLS) system. DESIGN Randomized controlled trial. SETTING On-field. PARTICIPANTS 116 athletes age 15-41 y, with 63 athletes in the control group and 53 athletes in the intervention group. INTERVENTION The intervention program in this randomized control trial was administered at the start of the basketball season 2010-11. The jump-landing training program, supervised by the athletic trainers, was performed for a period of 3 mo. MAIN OUTCOME MEASURES The jump-landing technique was determined by registering the jump-landing technique of all athletes with the JLS system, pre- and postintervention. RESULTS After the prevention program, the athletes of the male and female intervention groups landed with a significantly less erect position than those in the control groups (P < .05). This was presented by a significant improvement in maximal hip flexion, maximal knee flexion, hip active range of motion, and knee active range of motion. Another important finding was that postintervention, knee valgus during landing diminished significantly (P < .05) in the female intervention group compared with their control group. Furthermore, the male intervention group significantly improved (P < .05) the scores of the JLS system from pre- to postintervention. CONCLUSION Malalignments such as valgus position and insufficient knee flexion and hip flexion, previously identified as possible risk factors for lower-extremity injuries, improved significantly after the completion of the prevention program. The JLS system can help in identifying these malalignments. LEVEL OF EVIDENCE Therapy, prevention, level 1b.

Strategieën ter preventie van enkeldistorsies en voorstekruisbandletsels

Dit hoofdstuk geeft een overzicht van maatregelen die efficient zijn ter preventie van letsels bij volleybal en basketbal. De meest voorkomende letsels bij beide sporten zijn enkeldistorsies. De ernstigste letsels zijn die van de voorste kruisband. Een recent concept ter preventie van voorstekruisbandletsels is neuromusculaire training. Neuromusculaire training bestaat uit verscheidene trainingsmodaliteiten: sportspecifieke technieken (educatie), proprioceptieve balanstraining, krachttraining, snelheid en ‘agility’, en plyometrie (techniek). Bij neuromusculaire training wordt het accent gelegd op de kwaliteit van de uitvoering, niet op de kwantiteit. Er wordt een overzicht gegeven van de beoordeling, remediering en training van spronglandingstechnieken. Ook wordt de effectiviteit van proprioceptieve balanstraining ter preventie van (recidiverende) enkeldistorsies besproken en worden eenvoudige richtlijnen gegeven om toe te passen in de praktijk of op het sportveld.